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Article summary:

1. Off-label use of anticancer drugs in the United States: The article discusses the concept of off-label use, which refers to the use of approved drugs for clinical indications that have not been approved by the FDA. It highlights how drug companies are now allowed to promote off-label uses, and the major constraint is payers' willingness to cover the cost of these drugs.

2. Evaluation of off-label uses by Medicare: The article examines how Medicare evaluates off-label uses of cancer drugs. It mentions that Congress directed Medicare to use specific medical compendia as a source for reasonable practices in cancer chemotherapy. However, a study found that these compendia provided inconsistent, incomplete, and outdated information on off-label prescribing in oncology.

3. Need for change in evaluating off-label uses: The article calls for a change in the evaluation process for off-label indications that Medicare should pay for. It suggests implementing an ethically sound, logistically efficient, and financially prudent decision-making process to determine which off-label indications should be covered by Medicare. This would involve strengthening the current process and focusing on evidence-based practices.

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